Hepatitis A, San Diego and Public Health: It is Worse Than It looks

Analysis by Reporting San Diego
Oct 3, 2017 (San Diego) It is far worst than we thought. The public health crisis that exists in San Diego is worst than just housing policy gone wrong. According to the San Diego Union Tribune, not only are city and county officials blaming each other, but emails show utter contempt and neglect

According to an email obtained by them from June:

“From my understanding, the city of San Diego has declined an opportunity to put portable toilets/wash stations around the city because it wasn’t so long ago they were fighting other kinds of outbreaks by virtue of the availability of portable toilets,” Ruth Bruland wrote June 30.

The city has been warned that there is a need for public families downtown. They have resisted opening these facilities since they believe that this attracts drug users and prostitution.

The city has been warned by four Grand Juries that the lack of bathrooms could lead to a crisis. They were specifically warned in 2010 that this could result in severe liability to the city. Moreover, another Grand Jury also found that the County Sherriffs did not implement vaccination policies, as recommended by the Centers for Disease Control (CDC) at jail facilites operated by the department.

Here is the problem, insofar as the jail system is concerned. We have a high recidivism rate. Meaning, we have a population that keeps going in and out of jail, where they are exposed to preventable diseases, ranging from Hepatitis A to the flu.

The city has also said that the county health department should take the lead role on this. Why? They have more experience. But the problem is that this is a man made crisis. Rents are too high, high recidivism rates lead to people coming out of jail and back to jail. And now we have an outbreak, that could easily become an epidemic, on our hands.
The city, and the county, have policies that have tried to discourage things like homelessness. We are a growing region, and with the new economy, some in San Diego have benefited greatly. The city also promotes tourism, and conventions downtown. Part of the problem with the downtown area is that it is traditionally where homeless also congregate. Porta Potties do not look good, and are not conducive to attracting either new business or tourism. So the policy has been one at best of neglect.

Not only could the city and county be liable, but the region could get a hit to its self described image. This is of a region that contains “America’s finest city.” It is also bad management, and terrible public health. These policies, of benign neglect and attraction of high property values, with gentrification have created this crisis. To solve it, in the short term the city and the County need to take proactive public health measures. These include public bathrooms downtown, long term. Short term porta potties and portable wash stations need to be made available. Also a vaccination campaign at shelters, jails and with vulnerable populations needs to be carried out. Public health may require vaccinations at doctor’s offices as well.

However, the city needs to rethink development policies. Attracting high property values and catering to developers over the last generation has created the perfect conditions for this crisis. If the region is liable, and homeless advocates have reportedly filed lawsuits against the city. They have also called for California’s Attorney General Xavier Becerra to open an investigation against the city and the mayor. They are using the precedent established by Flint Michigan.

The City Council, under the leadership of Council President Myrtle Cole, has called for the redirection of funds, originally meant for a special election, to this effort.

While Councilmember Chris Ward released this statement regarding emergency shelters:

have spent most of this year calling for urgent action to provide sufficient shelter and services for the growing number of homeless people in San Diego, and today’s declaration of a Shelter Crisis and Public Health Emergency will speed up the process for implementing a sufficient response. We have all heard from San Diegans throughout the city that we have a responsibility to public health, to public safety, and most importantly to human decency to do more and do it immediately, and today’s Council vote demonstrates clear commitment to do more.

“We know our city’s emergency sanitation and vaccination response must also move beyond the ticketing and arrests that are pushing homeless individuals further into our neighborhoods, and by expanding and streamlining our rapid response options we can make sure we address the entire challenge before us. We cannot leave so many homeless San Diegans to fend for themselves on our streets and in our neighborhoods, and this Shelter Crisis declaration reduces red tape and unlocks more opportunities for the Mayor and City to quickly provide more shelter opportunities and safe, sanitary options to expand our response to the Hepatitis A outbreak and our ongoing homelessness emergency.”

This is hardly enough. Moreover, the city needs to adopt housing first policies, and stop with half hearted measures. If not, the crisis will continue to deepen.